RESUMO
INTRODUCTION: A phase II study of EPOCH chemotherapy in relapsed Hodgkin's disease was performed in 14 patients in a multicenter community setting. Patients and Methods. A total of 14 patients (9 males and 5 females) were included in the study. Ages ranged from 21-72 with a median age of 33. Eleven out of 14 patients had advanced (stage III or IV) disease, but all patients had good performance status. All 14 patients had received prior chemotherapy with ABVD, MOPP, or MOPP/ABVD hybrid. RESULTS: A total of 57 cycles of EPOCH were administered during this trial. Patients received a median of four cycles of chemotherapy. An overall response rate of 86% was seen among the 14 patients with one patient achieving a complete response. Following EPOCH chemotherapy, 7 of 12 patients who responded underwent high-dose chemotherapy with stem cell support. Six out of 14 patients are currently alive, and three had no evidence of disease at the time of last follow-up. Toxicity with EPOCH chemotherapy consisted mainly of myelosuppression, and most patients were managed on an outpatient basis. CONCLUSION: This multicenter community study confirms the activity of EPOCH chemotherapy in the treatment of patients with relapsed Hodgkin's disease.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Doença de Hodgkin/tratamento farmacológico , Administração Oral , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Ciclofosfamida/administração & dosagem , Doxorrubicina/administração & dosagem , Etoposídeo/administração & dosagem , Feminino , Transplante de Células-Tronco Hematopoéticas , Doença de Hodgkin/patologia , Humanos , Infusões Intravenosas , Injeções Intravenosas , Masculino , Pessoa de Meia-Idade , Prednisona/administração & dosagem , Análise de Sobrevida , Resultado do Tratamento , Vincristina/administração & dosagemRESUMO
We present the first case of Hantavirus pulmonary syndrome in the Dallas/Fort Worth area. The patient was a 50-year-old previously healthy white man, who had adult respiratory distress syndrome (ARDS) and hypotensive shock after 1 week of nonspecific "viral" symptoms. Despite supportive care, the patient died within several hours of presentation. This case illustrates several of the classic hallmarks of hantavirus infection such as hemoconcentration, thrombocytopenia, ARDS, and shock.
Assuntos
Síndrome Pulmonar por Hantavirus/diagnóstico , Adulto , Animais , Anticorpos Antivirais/sangue , Diagnóstico Diferencial , Evolução Fatal , Orthohantavírus/imunologia , Síndrome Pulmonar por Hantavirus/imunologia , Síndrome Pulmonar por Hantavirus/transmissão , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome do Desconforto Respiratório/diagnóstico , Roedores/virologia , TexasRESUMO
The inclusion of activated charcoal within hemodialysis membranes offers potentially improved plasma clearance of creatinine and middle molecules. However, the carbon becomes saturated with continued use and beyond 1 h removal of solutes is by dialysis alone. Two independently conducted crossover studies, to assess the efficacy of sorbent membrane dialysis (SMD) in the treatment of uremia, found predialysis urea levels increased by approximately 15%, creatinine by 10-15%, and inorganic phosphate levels by 10-18% on SMD compared to conventional hemodialysis. One study also observed "middle molecule' (peak "b') levels elevated. No differences were observable in the clinical status of patients. The results suggest that the charcoal content of the SMD device is too small to effect any advantages over conventional dialysis.
